Individual
DR. THOMAS J ROUSSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
329 WEST 40TH STREET, SCOTTSBLUFF, NE 69361-4634
(308) 635-3911
(308) 635-3130
Mailing address
329 WEST 40TH STREET, SCOTTSBLUFF, NE 69361-4634
(308) 635-3911
(308) 635-3130
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
18259
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102910000
—
WY
05
—
7796362
—
SD
Enumeration date
10/03/2006
Last updated
05/11/2021
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